Sonographic findings in three cases of carcinoma showing thymus‐like differentiation

Yamamoto, Yayoi; Yamada, Keiko; Motoi, Noriko; Fujiwara, Yoichi; Toda, Kazuhisa; Sugitani, Iwao; Kohno, Atsushi

doi:10.1002/jcu.21997

Cited by 15 publications

(15 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present study, ultrasound imaging of CASTLE identified a solid and hypoechoic mass, whose echo was typically heterogeneous. Yamamoto et al ( 15 ) studied the sonographic findings in three cases of CASTLE and concluded that CASTLE was solid and hypoechoic, with a heterogeneous echo pattern and without cystic components or calcifications, which is in agreement with the results of the present study. CASTLE was previously described as ‘cold nodule’ in ECT, suggesting that it was a malignancy ( 1 ).…”

Section: Discussionsupporting

confidence: 92%

Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid

Yao

Chen

et al. 2015

Oncology Letters

View full text Add to dashboard Cite

The aim of the present study was to summarize the clinical characteristics, diagnosis, treatment and prognosis of carcinoma showing thymus-like differentiation of the thyroid (CASTLE). A search of the relevant literature was conducted, which identified 82 cases of CASTLE reported to date. A review of the clinical and auxiliary examination data, treatment, pathological findings and follow-up of these cases was performed. The clinical manifestations of CASTLE varied and did not demonstrate specificity. During ultrasound examination, CASTLE was described as a solid and hypoechoic mass, and the echo was typically observed to be heterogeneous. In computed tomography (CT), CASTLE was demonstrated to be a well-defined, soft tissue density mass without calcification, which appeared enhanced following administration of contrast medium. In emission CT, CASTLE was revealed as a ‘cold nodule’. A total of 78 patients underwent radical surgery, and 12 patients experienced recurrence. Lymph node metastasis did not promote recurrence, and postoperative radiation was not able to reduce the recurrence rate (P=0.144 and 1.000, respectively). The median follow-up time was 14 months (range, 1–312 months). Typical immunohistochemical examinations demonstrated the specimens to be positive for cluster of differentiation (CD)5, CD117, cytokeratin 19, epithelial membrane antigen and tumor protein 63, and negative for calcitonin, thyroglobulin and thyroid transcription factor-1. Thyroid CASTLE is a rare malignancy whose exact diagnosis relies on pathological examination, particularly immunohistochemistry, since preoperative examinations are usually unable to provide an exact diagnosis. Radical resection is the primary treatment for CASTLE, which presents favorable prognosis.

show abstract

Section: Discussionsupporting

confidence: 92%

Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid

Yao

Chen

et al. 2015

Oncology Letters

View full text Add to dashboard Cite

show abstract

“…Pre-operative diagnosis of CASTLE is generally difficult, not only due to its non-specific clinical features, but also due to the lack of characteristic radiological features. Ultrasound features reported by Yamamoto et al include heterogeneously solid tumors without cystic components or calcification, and the central part of the tumor was reported to be slightly hyperechoic compared with the peripheral part of the tumor [8]. On non-contrast CT scans, the tumors are ill-defined and nodular, with uniform density.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Carcinoma Showing Thymus-Like Differentiation (CASTLE) with Tracheal Invasion: A Case Report

2019

View full text Add to dashboard Cite

Patient: Male, 49-year-oldFinal Diagnosis: Thyroid carcinoma showing thymus-like differentiation (CASTLE)Symptoms: HoarsenessMedication: —Clinical Procedure: ThyroidectomySpecialty: SurgeryObjective:Rare diseaseBackground:Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare disease entity. It arises from ectopic thymic tissue in the thyroid gland. Patients usually present with enlarging neck mass and hoarseness.Case Report:A 49-year-old man presented to our clinic with hoarseness and a right thyroid mass. Ultrasound showed a 6-cm right thyroid tumor and computer tomography confirmed invasion into the trachea. He received total thyroidectomy together with excision of one-third of the tracheal wall. No gross tumor was left behind. The tracheal defect was repaired using a pedicled right sternocleidomastoid muscle flap. He had a good recovery and was discharged 2 days after surgery. Histology revealed carcinoma showing thymus-like differentiation (CASTLE). The patient had regular follow-up and showed no clinical evidence of recurrence 18 months after surgery.Conclusions:Thyroid carcinoma showing thymus-like differentiation (CASTLE) is a rare yet potentially extensive disease with favorable prognosis. Imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), is helpful in aiding diagnosis and operative planning. Surgical resection is currently the treatment of choice, with generally favorable outcomes. The role of adjuvant therapies such as radiotherapy and chemotherapy require further studies.

show abstract

“…On ultrasound, CASTLE can be lobulated, solid, hypoechoic tumours without cystic components or calcification with heterogeneous internal echoes. 8 On plain CT scan, uniform isodensity could be seen in most tumours without calcification; cystic change is also rare, only in one case. On contrast-enhanced CT, mild enhancement was generally noted.…”

Section: Pathological Findingsmentioning

confidence: 82%

“…Until now, ,100 cases have been reported in the English literature, and the radiological imaging findings are solely limited to individual case reports. [6][7][8] Given the rarity of CASTLE, most radiologists are not familiar with it. Thus, we intend to report the CT and MR imaging appearances of 10 cases of CASTLE in this study along with a review of the relevant literature and also wish to raise awareness of this uncommon thyroid malignancy.…”

Section: Introductionmentioning

confidence: 99%

CT and MR imaging of thyroid carcinoma showing thymus-like differentiation (CASTLE): a report of ten cases

Wu¹,

Gu²,

Peng³

et al. 2016

BJR

View full text Add to dashboard Cite

Results: Seven patients with newly diagnosed and three patients with recurrent tumours were identified (six males and four females). CASTLE tumours were commonly located in the lower neck between the inferior pole of the thyroid and the upper mediastinum. The average tumour size was 4.2 cm (range: 2.5-6 cm). On plain CT scans, most tumours were ill-defined nodular masses of uniform density. After enhancement, most cases showed mild enhancement, while heterogeneous enhancement could be seen in more than half the cases. On the MR images, tumours presented with homogeneous isointensity on T 1

show abstract

Sonographic findings in three cases of carcinoma showing thymus‐like differentiation

Cited by 15 publications

References 11 publications

Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid

Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid

Thyroid Carcinoma Showing Thymus-Like Differentiation (CASTLE) with Tracheal Invasion: A Case Report

CT and MR imaging of thyroid carcinoma showing thymus-like differentiation (CASTLE): a report of ten cases

Contact Info

Product

Resources

About